Oral health for adults in care homes – NICE Guidelines

Oral health is essential to the general health and quality of life for service users in receipt of health and social care services.

It means being free from mouth and facial pain, oral and throat cancer, oral infection and sores, gum disease, tooth decay, tooth loss, and other diseases and disorders that limit a person’s ability to bite, chew, smile and speak. Poor oral health can contribute to malnutrition, which in turn can lead to increased risk of oral infections.

This NICE guideline covers oral health, including dental health and daily mouth care, for adults in care homes. The aim is to maintain and improve their oral health and ensure timely access to dental treatment.

Tooth decay and gum disease are the most common UK dental problems, but are largely preventable. They can be painful, expensive and seriously damage health if not treated

Oral cancer is rapidly increasing and half of new cases are in people aged 65 and over

Good quality information about oral health and dental needs in care homes is lacking. Many residents have complex oral health needs, but it is unclear how these are met

Practice varies across England. Poorly trained staff, lack of access to dental services and advice, existing oral health problems, medicines that decrease saliva, and treatments for chronic medical conditions (including dementia) make it difficult to identify and meet those needs

Research with adults in care homes with moderate to severe dementia has reported poor oral health

A 2012 British Dental Association survey (Dentistry in care homes research – UK) found inconsistent oral health care in care homes. It found many residents had oral health problems but staff were reluctant to help and lacked training. Care staff showed little understanding about the importance of oral health or its relationship with general health and a range of risk factors (for example, mouth cancer, cardiovascular disease, aspiration pneumonia). Poor oral health (leading to pain or infection) can also precipitate crises in people with dementia.

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